DAPCU

1. Presented by:
Harsh Rastogi,
NursingTutor,
M.S. Institute of Nursing,
Lucknow.

2.  HIV infection first detected in India in 1986,
when 10 HIV positive samples were found
from a group of 102 female sex workers from
Chennai.
 62 AIDS surveillance centers were gradually
established nationwide.

3.  1986: First case of HIV detected,AIDS task
force set by ICMR.
 1990: Medium term plan launched for 4
states & 4 metro
 1992: NACP 1 launched & NACB constituted.
 1999: NACP 2 begins, SACS established
 2002: NACP adopted.
 2004:ART started.
 2007: NACP 3 launched for 5 years.
 2012: NACP 4 launched for next 5 year.

4.  17 million people were accessing
antiretroviral therapy
 36.7 million [34.0 million–39.8 million] people
globally were living with HIV
 2.1 million [1.8 million–2.4 million] people
became newly infected with HIV
 1.1 million [940 000–1.3 million] people died
from AIDS-related illnesses

5.  78 million [69.5 million–87.6 million] people
have become infected with HIV since the
start of the epidemic
 35 million [29.6 million–40.8 million] people
have died from AIDS-related illnesses since
the start of the epidemic

6.  12,70,678 People on ART
 2116581 people were living with HIV
 75948 people became newly infected with
HIV
 67612 deaths due to AIDS
 35255 pregnant woman needs PPTCT

7.  High risk group:
 Female SexWorker (FSW)
 Men who have sex with Men (MSM)
 Transgender
 Injecting drug users (IDU)

8.  Bridge population:
 Migrant
 Truckers
 Clients of sex worker

9.  Vulnerable population:
 Women having casual partners
 Spouses of high risk groups

10.  High prevalence
 >5% in HRG & >1% in ANC
 MR,TN, Andhra, Manipur, Karnataka, Nagaland

11.  Moderate prevalence
 >5% in HRG & <1% in ANC
 Gujarat, Puducherry, Goa

12.  Low prevalence
 <5% in HRG & <1% in ANC
 All other states/UTs

13.  Districts are classified into four categoriesA
to D:
 Category A:
 More than 1% ANC prevalence in district in any of
the sites in the last 3 years.
 Category B:
 Less than 1% ANC prevalence in all the sites
during last 3 years with more than 5% prevalence
in any HRG site (STD/FSW/MSM/IDU)

14.  Category C:
 Less than 1% ANC prevalence in all sites during
last 3 years with less than 5% in all HRG sites,
with known hot spots (Migrants, truckers, large
aggregation of factory workers, tourist etc.)
 Category D:
 Less than 1% ANC prevalence in all sites during
last 3 years with less than 5% in all HRG sites with
no known hot spots OR no or poor HIV data.

15.  ADULTS:
 Positive test for HIV antibody by 2
separate test using 2 differentAntigens
plus
 Any one or more of the following:
 Weight loss >10% of bw
 Chronic diarrhea >1 month

16.  Chronic cough >1 month
 Disseminated ,military or extra-
pulmonaryTB
 Neurological impairment
 Esophageal candidiasis
 Kaposi sarcoma

17.  CHILDREN:
 At least 2 major signs + 2 minor signs
 Major:Weight loss, failure to thrive, chronic
diarrhea, prolonged fever, candidiasis,
Tuberculosis, Herpes zoster.
 Minor: Generalized lymphadynopathy,
Oropharyngeal candidiasis, persistent
cough for >I month, generalized dermatitis,
Confirmed maternal HIV infection.

18. Short, flu-like
illness occurs
1-6 weeks after
infection
Infected person
can infect other
people
Average- 10
years
Mild symptoms
HIV in blood
drops to very
low levels
Antibodies are
detectable in
the blood
The immune system
deteriorates
Opportunistic
infections (OI)start to
appear
Rapid
the
decline in
number of
CD4+ Tcells
Opportunistic
infections become
severe and cancer
may develop

19.  HIV infection first detected in India in 1986,
when 10 HIV positive samples were found
from a group of 102 female sex workers from
Chennai.
 In 1986 Government set up an AIDSTask
Force under ICMR and established a National
AIDS Committee (NAC) chaired by Secretary,
Department of Health and FamilyWelfare.
 In 1987, NationalAIDS Control Programme
was initiated, with help from theWorld Bank.

20.  In 1989, a MediumTerm Plan for AIDS Control
was developed with the support of theWHO.
 First NationalAIDSControl Programme
(NACP-I) was launched in 1992.
 NACP-II launched in 1999: decentralization
of programme implementation to State level
and greater involvement of NGOs.
 NACP- III implemented during 2007-2012.
 NACP-IV has been developed for the period
2012-2017.

21.  Objective
 Slow and prevent the spread of HIV through
a major effort to prevent HIV transmission.
 Key strategies
 Focus on raising awareness, Blood safety,
Prevention among high-risk populations,
 Improving surveillance

22.  Achievements
 NationalAIDS response structures at both
the national and state levels and provided
critical financing.
 Strong partnership with theWorld Health
Organization (WHO) and later helped
mobilize additional donor resources.
 Established the StateAIDS Control Cells

23.  Objective
 Reduce the spread of HIV infection in India
through behavior change and increase capacity to
respond to HIV on a long-term basis.
 Key strategies
 Targeted Interventions for high-risk groups
 Preventive interventions for general populations
 Involvement of NGOs
 Institutional strengthening

24.  Achievement
 At the operational level 1,033 targeted interventions set
up, 875Voluntary counseling and testing centers (VCTC)
and 679 STI clinics at the district level.
 Nation-wide and state level Behaviors Sentinel
Surveillance (BSS) surveys were conducted.
 PPTCT Expanded.
 A computerized management information system (CMIS)
created.
 HIV prevention and care and support organizations and
networks were strengthened.
 Support from partner agencies increased substantially.

25.  Objective
 Reduce the rate of incidence by 60 per cent in the first year
of the programme.
 Strategies
 Prevention –Targeted intervention (TI), ICTC, blood safety
 Care, support and treatment-
 Capacity building – establishment, support and capacity
strengthening, training, managing programme
implementation and contracts, mainstreaming/private
sector partnerships.
 Strategic information management–monitoring and
evaluation.

26.  Achievements
 There were 306 fully functional ART Centers.
 Nearly 12.5 lakh PLHIV were registered and 420000 patients
were on ART.
 612 Link ART centre (LAC) had been established wherein, 26023
PLHIV were taking Services
 There were 10 Centers of Excellence,
 7 Regional Pediatric centers also functional.
 259 Community Care Centers across the Country
 6000 condoms & 6000 village information centers established
 3000 Red ribbon clubs established
 Link Workers training module updated

28.  Launched on 12 February 2014.
 Total budget outlay Rs 14295 crores.
 Goal: Accelerate Reversal and Integrate
Response.
 Objective 1:
 Reduce new infections by 50% (2007 Baseline of
NACP III)
 Objective 2:
 Provide comprehensive care and support to all
persons living with HIV/AIDS.

29.  Preventing new infections by sustaining the
reach of current interventions and effectively
addressing emerging epidemics.
 Prevention of Parent to Child transmission
 Focusing on IEC.
 Providing comprehensive care, support and
treatment to eligible PLHIV
 Reducing stigma.

30.  De-centralizing rollout of services including
technical support
 Ensuring effective use of strategic
information at all levels of programme.
 Building capacities of NGO and civil society
partners especially in states with emerging
epidemics.
 Integrating HIV services with health systems
in a phased manner.
 Mainstreaming of HIV/ AIDS activities.

31.  Targeted Interventions for High Risk Groups
and Bridge Population.
 Needle-Syringe Exchange Programme
(NSEP) and Opioid SubstitutionTherapy
(OST) for IDUs.
 Prevention Interventions for Migrant
population at source, transit and destination.
 LinkWorker Scheme (LWS) for HRGs and
vulnerable population in rural areas.

32.  Prevention & Control of SexuallyTransmitted
Infections/ReproductiveTract Infections
(STI/RTI)
 Blood Safety
 HIV Counseling &Testing Services
 Prevention of Parent to ChildTransmission
 Condom promotion
 Information, Education & Communication
(IEC) & Behavior Change Communication
(BCC).

33.  Laboratory services for CD4Testing and other
investigations.
 Free First line & second lineAnti-Retroviral
Treatment (ART) through ART centers and
Link ART Centers (LACs), Centers of
Excellence (COE) & ART Plus Centers.
 PediatricART for children.

34.  Early Infant Diagnosis for HIV exposed infants
and children below 18 months.
 HIV-TB Coordination (Cross referral,
detection and treatment of co-infections)
 Treatment of Opportunistic Infections
 Drop-in Centers for PLHIV networks

35.  Scale up of Multi-Drug Regimen for
Prevention of Parent to ChildTransmission
(PPTCT).
 Social protection for marginalized
populations through mainstreaming and
earmarking budgets for HIV among
concerned government departments.
 Establishment of Metro Blood Banks and
Plasma Fractionation Centre.

36.  Launch ofThird LineART and scale up of first
and second LineART.
 Demand promotion strategies specially using
media, e.g., National Folk Media Campaign &
Red Ribbon Express and buses.

37.  NationalAIDS Control Organization. About NACO; NACO 2013.
Available from: http://www.nacoonline.org/About_NACO/ .
 MSACS–Maharashtra stateAIDS control society.
Mahasacs.org.in
 India HIV estimations 2015Technical Report , NACOAND
National Institute of Medical statistics , ICMR, Ministry of
Health and FamilyWelfare, New Delhi
 Textbook of Park, 23 rd Edition, page no. 343-354 , 431-438
 Textbook of Suryakanta, 4th Edition , 498-519, 924- 930, page
no. 387- 391
 WHO Guidelines for ART 2013
 Factsheet Statistics 2015- UNAIDS
 Textbook of national health programmes of India , national
policies and legislations related to health, J. KISHORE, 11th
Edition.

38. Thank you!